Starting a practice

[Perrotfish]

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Some questions on starting my own office, for those who have done it.

1) How do you attract patients? How do you advertise? DO you associate with a hospital? I'm with Pediatrics so I imagine working in a nursery will be key but is there anything else?

2) How much of an initial investment is reasonable if you want to do it without loans?

3) I'm planning on doing this in about 3 years, if I do it at all. Other than medical education, is there any degree or training you guys would recommend?

4) For the DPC model, do you offer limited time only pricing? How do you decide what to charge?

5) For non-DPC model clinics, how would you recommend learning to code better?

6) What do you think is a viable number of people to start a practice with these days? I mean, obviously one guy can open a clinic, but that means holiday coverage is going to be kind of rough and its hard to share support staff.

7) Just out of curiosity, do you guys pay attention to any standardized measurements of quality in your private practices? Do big clinic buzzwords like HEDIS and Family Centered home just fade away or do you try to incorporate them somehow?

8) How long should I expect to wait before some if the revenue starts coming back to me, rather than just to the clinic?

9) Any other advice?

 

[JustPlainBill]

Some questions on starting my own office, for those who have done it.

1) How do you attract patients? How do you advertise? DO you associate with a hospital? I'm with Pediatrics so I imagine working in a nursery will be key but is there anything else?

2) How much of an initial investment is reasonable if you want to do it without loans?

3) I'm planning on doing this in about 3 years, if I do it at all. Other than medical education, is there any degree or training you guys would recommend?

4) For the DPC model, do you offer limited time only pricing? How do you decide what to charge?

5) For non-DPC model clinics, how would you recommend learning to code better?

6) What do you think is a viable number of people to start a practice with these days? I mean, obviously one guy can open a clinic, but that means holiday coverage is going to be kind of rough and its hard to share support staff.

7) Just out of curiosity, do you guys pay attention to any standardized measurements of quality in your private practices? Do big clinic buzzwords like HEDIS and Family Centered home just fade away or do you try to incorporate them somehow?

8) How long should I expect to wait before some if the revenue starts coming back to me, rather than just to the clinic?

9) Any other advice?

For the record, I do not have my own solo practice -- after long consideration of joining a very nice heavily workman's comp/industrial medicine concern vs a partnership as an employed physician to start with, I decided to go with the employed physician in the partnership to gain experience in general FM with some more experienced physicians available if I needed them ---

Anyway

1) You generally get on insurance plans -- a good billing service can help you with this and there's also physician collective bargaining groups (I forget what they're called) that can help, you go around to all the Urgent Care/ER places and drop off cards and cookies, you speak to the local Kiwanis/Rotary/Boy Scouts, volunteer at indigent care clinics, etc.

2) Don't know

3) Get as much training in whatever you didn't get in residency as possible -- eyes, ortho,derm, procedures especially

4) See AtlasMD

5) A good EMR can be a lifesaver -- plus experience in coding

6) You'll have to walk that road alone for a while -- once you're viable, then you can start having a PA/NP -- usually the number is 18-24 patients per day for one provider before you can call yourself profitable.

7) again, EMR/Medicare/Medicaid can help you with the standard measures --as will ABFM/AAFP -- typically these are BP, A1C, eye exams,CKD measures, etc.

8) My wife does small business startup accounting and has several physicians as clients -- she tells me that on average it's about 1-2 years, depending on how aggressive the physician is -- most moonlight during this time period.

9) Good luck to you --- I would seriously look into DPC and talk with AtlasMD -- right now, I'm using the next 3 years to gain the experience/confidence needed and then, unless I'm a partner by then, I'll be doing my own thing with DPC.

 

[Ericslv]

You can also look at Pamela wibble model.

 

[VA Hopeful Dr]

Some questions on starting my own office, for those who have done it.

1) How do you attract patients? How do you advertise? DO you associate with a hospital? I'm with Pediatrics so I imagine working in a nursery will be key but is there anything else?

2) How much of an initial investment is reasonable if you want to do it without loans?

3) I'm planning on doing this in about 3 years, if I do it at all. Other than medical education, is there any degree or training you guys would recommend?

4) For the DPC model, do you offer limited time only pricing? How do you decide what to charge?

5) For non-DPC model clinics, how would you recommend learning to code better?

6) What do you think is a viable number of people to start a practice with these days? I mean, obviously one guy can open a clinic, but that means holiday coverage is going to be kind of rough and its hard to share support staff.

7) Just out of curiosity, do you guys pay attention to any standardized measurements of quality in your private practices? Do big clinic buzzwords like HEDIS and Family Centered home just fade away or do you try to incorporate them somehow?

8) How long should I expect to wait before some if the revenue starts coming back to me, rather than just to the clinic?

9) Any other advice?

1. Depends. If you're doing just a standard pediatrics practice, then insurance panels and nursery work will be your main sources. If you decide to do DPC, most of us have gotten great returns from radio ads.

2. Again, depends. Its easy enough to price up equipment. Luckily, pediatrics is not so procedure heavy that you'll need lots of equipment. After that, rent and staffing will be your major costs. To be safe, I would budget 200k though you could get by with less if you moonlight heavily at the start.

3. AtlasMD has a reading list, tackle it.

4. No to the first. Honestly, I copied Atlas since Josh has the numbers worked out already. No need to reinvent the wheel.

5. Lots of online coding workshops to choose from. The AAFP has some good coding stuff too.

6. Not really sure on this one since I'm only DPC.

7. Not applicable for me

8. I'm waiting for all the bills to be paid every month before I start paying myself.